{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:21:58Z","timestamp":1767687718602,"version":"3.48.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>If severe acute pancreatitis (SAP) is complicated by disseminated intravascular coagulation (DIC) or walled-off necrosis (WON), the mortality rate may increase. Therefore, prevention of the development of WON and treatment of DIC are likely to play important roles in improving survival in SAP. Although recombinant human soluble thrombomodulin (rhTM) might play a useful role in treating DIC, the impact of rhTM on improving survival and resolution of DIC due to SAP is still unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the clinical impact of rhTM in patients with SAP and DIC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A single-center retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>The patients were divided into two groups: the rhTM group and the non-rhTM group, in which rhTM was not administered. The primary outcome was the DIC resolution rate at 7\u2009days after starting treatment. The mortality rate at 28\u2009days was secondarily evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 321 SAP patients, 63 patients were complicated with DIC, and they were divided into rhTM (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200928) and non-rhTM (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200935) groups. The rate of development of WON was significantly higher in the non-rhTM group (51.4%, 18\/35) compared with the rhTM group (25.0%, 7\/28) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.033). The resolution rate of DIC within 7\u2009days was significantly higher in the rhTM group (89.3%, 25\/28) compared with the non-rhTM group (60.0%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20099\/35) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.009). The mortality rate within 14\u2009days, which might have been strongly influenced by the presence of DIC, was significantly higher in the non-rhTM group (20.0%, 7\/35) compared with the rhTM group (0%, 0\/28) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01). According to multivariate analysis, rTM non-administration was an independent factor for failed DIC resolution or developing WON.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In conclusion, rhTM may play a role not only in improving the resolution rate of DIC and improving the survival rate of SAP, but also in preventing the development of WON.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848251353626","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T07:12:42Z","timestamp":1752477162000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical impact of recombinant thrombomodulin administration on disseminated intravascular coagulation due to severe acute pancreatitis (Recover-AP study)"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2916-6568","authenticated-orcid":false,"given":"Takeshi","family":"Ogura","sequence":"first","affiliation":[{"name":"Advanced Pancreatobiliary Medical Center, Endoscopy Center, Osaka Medical and Pharmaceutical University, 2-7 Daigakuchou, Takatsukishi, Osaka 569-8686, Japan"},{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saori","family":"Ueno","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akitoshi","family":"Hakoda","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Okuda","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobu","family":"Nishioka","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Matsuno","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Uba","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuki","family":"Tomita","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Hattori","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, 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